This blog documents the journey of Marla Crider, a 60 year-old travel professional from Little Rock, Arkansas, as she battles a breast cancer called invasive ductal carcinoma (stage 3). From the moment of her diagnosis, she chronicles her experience. Be forewarned this blog may provide a raw glimpse into the author’s psyche and ability to deal with a life threatening challenge. Hopefully, her honesty and humor will provide advice and help to others who find themselves in a crusade of their own.

Monday, June 23, 2014

Houston: We Have a Problem

When Dr. Makhoul informed me nearly two months ago that the
triple negative breast cancer had metastasized to my lungs, liver and pelvis,
we made a joint decision to try a powerful oral chemo – Xeloda (zeloda) - as well as a bone enhancer/strengthener
called Zomata that is to be given intravenously once a month.

M.D. Anderson Cancer Institute - Houston, TX

I was instructed to take 1,500 milligrams of the Xeloda in
the morning and evening for two weeks with one week off the drug. After week one, the “hand and foot” syndrome that Dr.
Makhoul warned me about had made itself known. Occasionally, the bottoms of my
feet would be so tender that it was a challenge to walk. I learned quickly that
washing my hands in hot water was a no-no and showering in hot water wasn’t
tolerable, either. Tepid temperatures
were the new norm in my life.

During the week off the oral chemo, I could almost hear my
body take a deep sigh of relief. My
hands and feet returned to their usual flesh tone and my digestive system was
craving Mexican food. I now understood why the doctors allowed a one-week
vacation from the Xeloda. I had earned
the time off.

The second, two-week cycle of the drug started off
uneventful; however, at the end of the first week, the hand and foot syndrome
returned with a vengeance and my diet no longer included spicy food. New to the side effect menu was a generous helping
of fatigue. My body and brain were
exhausted by the end of each work day.
It was a challenge when I got home to prepare something to eat or even
muster an appetite.

By the end of the cycle, my hands and feet were extremely
sensitive and tingled night and day.
Diarrhea continued to be my nemesis and the fatigue was ever
present. I was anxious to see Dr.
Makhoul for my one-month, follow-up appointment that coincided with the end of
the second, two-week cycle and hear what he had to say about the side
effects.

My appointment was on May 16. Don and I arrived at UAMS for the required
blood work at 11:00 a.m. We were to see
Dr. Makhoul at 12:00 p.m. From a year’s
worth of experience, we knew we were in for a one to two-hour wait. It was 2:40 p.m. when we finally saw the
smiling face of the good doctor. He
apologized, which was unnecessary. When
you have cancer, you learn patience.
And, if you expect the best doctors to treat you, it is a given that
they constantly run behind schedule because they are providing others with the
same detailed and compassionate care that you are privileged to have.

Dr. Makhoul reviewed the list of my side effects and
explained that I would probably have to start wearing socks and tennis shoes
when my feet were inflamed. Being the
fashion diva that I am, I laughed out loud at the thought of me wearing the
likes of socks and tennis shoes to work.
I would figure out another solution – a stylish solution - to aid my
pitiful feet.

During our conversation, Dr. Mak informed me that he was
scheduling a new PET scan for May 30 to see how the Xeloda was impacting the
cancer. The results would be shared with
me on June 2 but not by Dr. Makhoul. He
was scheduled to be out of town. His
nurse practitioner would deliver the results to me after he reviewed the scans
and read the radiologists comparison report.
Dr. Mak also wrote a partial prescription for two week’s worth of Xeloda
that would get me through until the June 2nd appointment.

After we left Dr. Makhoul’s office, Don and I reported to
Infusion 1 for my monthly, intravenous dose of Zomata. When we arrived at 3:30 p.m., the waiting
area was filled with disgruntled patients, who had been waiting for their
chemotherapy for hours. Apparently, UAMS installed a new, state-of-the-art
patient charting system that drastically slowed down the chemotherapy infusion
process and other out-patient units at the medical center. In addition, the new
system crashed twice earlier in the day, creating a back log of patients
waiting for their chemo.

Finally, I was called back at 5:15 to receive the 15-minute
I.V. dose of Zomata. While I was
exhausted from being at the med center for more than six hours (and most of it
spent in waiting rooms), I actually felt sorry for the Infusion nurses who had
no choice but to listen to people complain about the lengthy delays at the same
time they were hooking them up to the poison that was supposed to cure
them. Trust me; these dedicated health
professionals earn their pay.

For the next two weeks, I faithfully took the Xeloda while
my hands and feet continued to show signs of irritation and even began peeling
“sheets” of skin. I thought I was going to have to take Dr. Makhoul’s advice
and wear socks and tennis shoes, when I found a pair of old-fashioned, “jelly”
shoes that felt like I was walking on a cloud.
They saved my poor, throbbing, peeling feet. The fatigue intensified in
that two week period, as did my constant companion, diarrhea. If I was to adopt
my significant other’s medical philosophy – the worse the side effects, the
better its working - then the Xeloda must really be kickin’ butt for me to
endure these intense side effects. The
next PET scan would tell the tale.

I reported for the PET scan on May 30 after eating a no-carb
diet the previous day/night. PET scans are tricky for diabetics because the
radioactive concoction they inject in the system to track cancer cells is
almost pure sugar. It’s important to
have a fasting blood sugar of less than 250.
When the radiology tech took a blood sample and tested it, my blood
sugar was a whopping 195. Since
finishing chemo last year, my blood sugar has been well controlled and never
that high. I was within the limit, so
they continued with the PET scan, which takes about 30 minutes. While the whirling X-ray machine made its way
up and down my body, I had a lengthy conversation with God. When I left the
X-ray room that day, I was at peace.

Don and I coordinated our schedules and went to UAMS
together for the PET scan results. We had been waiting only a few minutes when
the nurse practitioner, Donna, entered the exam room. She
introduced herself then sat down in front of the computer and pulled up my scan
results. She slowly turned around to
face me and said Dr. Makhoul had reviewed the scans and narrative report from
the attending radiologist and, unfortunately, the news was not good.

“The oral chemo has not had any impact on the cancer,” she
reported. As I looked at Donna’s ashen,
somber face, I knew there was more bad news to come. “Dr. Makhoul is recommending that you go to
M.D. Anderson Cancer Institute in Houston
for a consult and alternative treatment plan.”
And, there it was.

I was without emotion.
Don rubbed my back, anticipating there might be a few tears. He knows me better than that. I’m in the
battle of my life and there is no time or energy for a meltdown.

I asked Donna if Dr. Makhoul felt he had run out of
treatment options and she was quick to respond, “No.” She reassured me that the reason he wants me
to report to M.D. Anderson is that the facility is a little further along with
research and trial treatments for triple negative breast cancer, which is my
cross to bear.

Donna told me that the referral from Dr. Makhoul was being
sent to M.D. Anderson that afternoon, along with all of my medical records
dating back to my cancer diagnosis in May 2013. She explained that I would get a call from Houston within a few days
with my appointment date.

Marla Crider and Don Vowell

Yet again, Don and I silently departed the Winthrop P.
Rockefeller Cancer Center in silence, which was happening much too frequently
of late. It was mid-afternoon and all I
wanted to do was go back to work and focus on anything but cancer. Don asked if I wanted him to stay with me
that night. I explained that I really
needed the time to process the latest results by myself. As a trained physician, he understood.

One of the most difficult things I did that afternoon was
tell my friends and colleagues at the office – the Arkansas Department of Parks
and Tourism. They were waiting anxiously
to finally hear some good news from me.
It wasn’t easy watching Gloria and Savannah
fight back the tears when I shared the results with them. And Linda, who has a
quip for everything, was speechless.

That evening I had to make the dreaded call to my
brothers. The silence on the other end
of the phone was deafening. I told them both that when I travel to M.D.
Anderson, I would like for one of them to go with Don and me. My older brother, Mike, made the decision to
accompany us to Houston.

A few days later, I received a call from my newly assigned patient
liaison, Carneshu, who told me that my M.D. Anderson appointment was scheduled
for July 14. I was stunned that it would
be five weeks before I would report to the cancer institute. All she told me was that the delay was necessary. Later, I learned that all the oral chemo must
be out of my body before the cancer specialists in Houston could/would see me. That explanation didn’t help my eagerness to
get this show on the road, but I had no choice.

When you have cancer, the worst news you can hear is that
the disease has claimed another breast cancer “sister.” I’m dealing with that reality as I write this
blog. My dear friend and former
colleague, Cindy, passed away this weekend after fighting this horrible disease. When I was first diagnosed in May of 2013,
Cindy was one of the first people to contact me and talk me through chemo and
what I might expect. Her guidance was so
helpful. Cindy was only 50 when she
died and a true inspiration to many of us who continue the battle. Ahhh, Cindy… you were like my younger sister
and I could not be more proud that you fought so gallantly and with such
dignity.

These days, I think often about my pending July 14 journey
to M.D. Anderson in Houston and that famous statement from the movie Apollo 13
always comes to mind: “Houston, we have a
problem.” And, boy, do we! Now,
more than ever before, I am very determined that “Houston” is going to get me back on the path
to recovery. Oh, for the day that I can
yell from the State Capitol steps, “Houston,
we no longer have a problem.”

5 comments:

Marla--keep a strong sense of peace in your soul, heart, and mind. It will give you the strength you need for your trip to Houston. Know that you are continually in my daily thoughts and prayers for you as you fight this battle against cancer. Get well again, my friend. Affectionately--Melinda Baran

Mama, we are going to trail-blaze through this one! You are the inspiration to all of us breast cancer warriors-with every step you take, you are helping all of us learn how to handle every situation, granted we may be carrying a few cinder blocks with us, but hang on, Houston is on standby, suit up and let's get this cancer kicked to the moon! Love ya bunches!

Hello everyone, I was infected with the herpes virus and I got cured of the herpes virus few months ago after i contacted Dr Ero. I saw a post on the internet after i have seek healing for several years from different doctors in California. I sent the Doctor a request for help, just a few email i followed his instruction and he sent me the medication after i paid him. Now i am negative and i referred him to all my friend who had this same sickness and they have gotten their cure too. You can contact him via his email. dreroherbaltreatment@gmail.com . Thank You Dr Ero and text me for further information (650) 653-8578..

About Me

Marla Crider, a 60 year-old travel professional from Little
Rock, Arkansas, is blogging her battle with invasive ductal carcinoma or in layman’s terms –
breast cancer. From the moment she discovers the lurking lump in her right
breast, she apprehensively chronicles her thoughts and emotions for public
scrutiny. Be forewarned that these postings may provide a raw glimpse into the
author’s psyche and ability to deal with a life threatening challenge. Hopefully,
Marla’s honesty, humor, and prose approach of dealing with her diagnosis and
subsequent treatment plan will help others who find themselves in a crusade of
their own. You may follow her journey here: www.MarlaCrider.com . Marla has lived and worked previously in Fayetteville, Arkansas and Hot Springs, Arkansas.

Invasive Ductal Carcinoma: What is it?

Invasive ductal carcinoma (IDC) is the most common form of invasive breast cancer. It accounts for 80% of breast cancer incidence upon diagnosis, according to statistics from the U.S. in 2004. On a mammogram, it is usually visualized as a mass with fine spikes radiating from the edges. On physical examination, the lump usually feels much harder or firmer than benign breast lesions such as fibroadenoma. On microscopic examination, the cancerous cells invade and replace the surrounding normal tissues.

Mammograms

Breast tissue is composed of fatty (nondense) tissue and connective (dense) tissue. Radiologists use a grading system to describe the density of breast tissue based on the proportion of fat to connective tissue. There are four levels of density that are detected by mammograms: Level 1 (a very fatty breast), level 2 (fatty tissue makes up more than 50 percent of breast), level 3 (dense tissue makes up more than 50 percent of the breast) and level 4 (a very dense breast with very little fat). Click the image above for more information from the Mayo Clinic.

Get a Breast Cancer Screening

Click map to find a screening site near you.

All original content copyright (c) 2013, Marla F. Crider and marlacrider.com. You are free to share (copy, distribute and transmit) content from this site with attribution to marlacrider.com.